Mills Edward, Singh Sonal, Roach Brenda, Chong Stephanie
Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
Med Confl Surviv. 2008 Jan-Mar;24(1):5-15. doi: 10.1080/13623690701775171.
The mass expulsion and exile of Bhutanese de facto refugees to displaced camps in Nepal represents one of the world's most neglected humanitarian crises. We aimed to summarize the impact of the long-term displacement on refugee mental illness using systematic review techniques, a methodology seldom used in the humanitarian field. In order to examine the impact among the population and the association between tortured refugees over non-tortured refugees, we searched 11 electronic databases from inception to 12 May 2006. We additionally contacted researchers at the United Nations High Commission for Refugees (UNHCR) and at the Centre for Victims of Torture, Kathmandu, and searched the websites of Amnesty International, Human Rights Watch, Relief-Web, and the US State Department. We included any studies that use a pre-defined protocol to determine mental illness within this population. Six studies met our inclusion criteria. All were conducted amongst the Bhutanese populations residing in Nepalese refugee camps, and include a sub-sample of 2,331 torture survivors residing in the camps, identified in 1995. All studies report a dramatically high incidence of mental illness including depression, anxiety and post-traumatic stress disorder. Both tortured and non-tortured participants reported elevated rates of mental illness. Our review indicates that the prevalence of serious mental health disorders within this population is elevated. The reported incidence of torture is a possible contributor to the illnesses. The use of systematic review techniques strengthens the inference that systematic human rights violations were levied upon this population and that they continue to suffer as a result. The international community must resolve this protracted crisis.
不丹事实上的难民被大规模驱逐并流亡至尼泊尔的流离失所者营地，这是世界上最被忽视的人道主义危机之一。我们旨在运用系统综述技术总结长期流离失所对难民精神疾病的影响，而这种方法在人道主义领域很少被使用。为了研究这一人群中的影响以及遭受折磨的难民与未遭受折磨的难民之间的关联，我们检索了从建库至2006年5月12日的11个电子数据库。我们还联系了联合国难民事务高级专员公署（难民署）以及加德满都酷刑受害者中心的研究人员，并搜索了大赦国际、人权观察、救济网和美国国务院的网站。我们纳入了任何使用预先定义方案来确定该人群中精神疾病的研究。六项研究符合我们的纳入标准。所有研究均在居住于尼泊尔难民营的不丹人群中进行，其中包括1995年确定的居住在营地的2331名酷刑幸存者子样本。所有研究均报告了包括抑郁症、焦虑症和创伤后应激障碍在内的精神疾病的极高发病率。遭受折磨和未遭受折磨的参与者均报告精神疾病发病率升高。我们的综述表明，这一人群中严重精神健康障碍的患病率有所上升。报告的酷刑发生率可能是导致这些疾病的一个因素。系统综述技术的运用强化了这样的推断，即该人群遭受了系统性的人权侵犯，并且他们仍因此而受苦。国际社会必须解决这一旷日持久的危机。
